Common Duct Stone Producing Charcot's Hepatic Fever Without Jaundice

Abstract

Illnesses characterized by recurring attacks of fever often constitute baffling diagnostic problems. In the differential diagnosis of such illnesses one usually includes the intermittent fever associated with obstruction of the common bile duct. A history characteristic of biliary colic or the presence of clinically detectable jaundice in such patients considerably lessens one's diagnostic difficulties. Charcot's fever unassociated with such focalizing signs or symptoms can represent an enigma. We recently encountered three patients whose fevers were associated with stones in the common bile duct. These patients did not have clinically detectable jaundice, nor did they give a history diagnostic of biliary colic. Because of the interest in Charcot's fever generated among us who participated in the care of these patients, we examined the files of the Mayo Clinic for the five-year period, 1951 to 1955, inclusive, in search of similar cases. All cases of choledocholithiasis found at operation or necropsy during